Share This:

Psychotherapy helps in recovery from depression, but you may not be ready to verbalize feelings, revisit a painful past, or make needed changes.

By Deborah Serani, PsyD

Is psychotherapy always a good idea?

While psychotherapy helps many people with depression get better, the truth is that it’s not automatically a good fit for everyone at every point in their recovery journey.

The work typically requires that you be open and verbal, which can be extremely tough for some people. Certain therapeutic approaches focus greatly on feelings, which may be too emotionally overwhelming at the moment. It may be that the course of therapy involves exploring past trauma or painful moments in your life that you’re reluctant to revisit.

Or maybe your depression is so overwhelming you don’t have the physical energy or emotional strength to apply techniques learned in your sessions—or make it to your therapist’s office in the first place.

You probably won’t leave every session feeling happy, relieved, or that you’ve made a breakthrough. In fact, the process may leave you feeling worse before you feel better, and that can be discouraging. The road towards change is not a straight line, and “one step forward, two steps back” may not be a comfortable road to walk.

As a clinician, I believe it’s important to determine at the first session whether treatment will be a good match for the individual. I recommend that everyone considering therapy look at:

ABCs: It’s vital to know how talk therapy works and what to expect. For example, psychotherapy isn’t advice-giving. It’s an experience where you learn about yourself so you can develop new coping methods. Talk therapy generally isn’t a fast fix. It may take some time for you and your therapist to identify and alter negative patterns.

Metrics:Develop clear goals and a timeline for when you should be feeling better. That way you can measure whether your symptoms of depression are easing, staying the same, or worsening.

Also consider how the financial and insurance pieces work together. This gives you a practical basis for how long you may want to pursue psychotherapy.

Fit: Discuss the kind of treatment your therapist practices. Behavioral therapy focuses on patterns in your actions and reactions, while cognitive therapy addresses how you think about people and things. Psychodynamic therapy looks at past traumas or your attachment to others. If you decide your therapist’s treatment approach doesn’t suit your needs, you’ll want to look for another practitioner.

After a few sessions, it’s time to assess how things are going. If the work is proving meaningful, we continue. When people aren’t very talkative, find the experience difficult, or aren’t comfortable with the mechanics of talk therapy, I let them know it’s OK not to continue.

Sometimes the timing isn’t right to begin therapy. Further down the line, changes in your circumstances or perspective may make you feel ready to give it another try.

What are my other options?

Self-help avenues can be a way to learn mindfulness and other techniques that help to reduce depression. Possibilities include reading books and magazine articles; connecting online to mental health websites; and attending workshops, seminars and local support groups.

Studies show that such self-help approaches are often successful for adults who have mild depression.

However, when it comes to moderate or severe depression, self-help may not be enough.

Evidence-based studies tell us three important things: First, talk therapy of various kinds is a successful treatment for depression. Second, medication lessens depressive symptoms for most patients. And third, use of both at the same time offers the best levels of recovery.

If you have a depression that goes beyond the mild range and you find talk therapy less outside your comfort zone, it’s all the more vital to work with an appropriate professionalto find an antidepressant that remedies your symptoms.

Deborah Serani, PsyD, is a licensed psychologist in private practice, a faculty member at Adelphi University, and the author of Living with Depression, Depression and Your Child, and Depression in Later Life: An Essential Guide (due out in June). She also manages her own depression, which was diagnosed in 1980.

SoundOFF!

HEALTHY HABITS

Most of us don’t default to healthy habits. It takes planning and effort, and sometimes a surge of self-discipline, to eat right, exercise, get the sleep we need, and stay on top of work and life tasks. Establishing new habits, let alone purging bad ones, can require major effort, especially if we are also struggling with depression or anxiety. What are some good habits that you've formed and how did you build them?